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Friday, January 4, 2013

Edgar Schoen Showing His Age

In a reality where circumcision is increasingly falling out of favor, Edgar Schoen appears to be absorbed in an idealistic dreamworld, where citizenship to a country is marked by being male, and whether or not his penis has been mutilated at birth.

In an article he wrote for JWeekly recently, he raves on about circumcision being "the norm" in this country, touts the so-called "medical benefits" of it, and plugs infant circumcision using rather out-dated propaganda. In the end, though, Schoen reveals his true interests in infant circumcision, as he brow-beats Jewish parents who are beginning to abandon the practice.

In this blog post I take apart his most recent circumcision plug piece.

Schoen describes the world of his fantasies on JWeekly"In this country, circumcision is the norm. According to the
Center for Disease Control and Prevention, 89 percent of non-Hispanic
white males in the United States are circumcised. If an American boy is
uncircumcised, it generally means his parents are immigrants, usually
Hispanic, or low-income."

I'd like to take this opportunity to point out how the very idea of opposing male infant circumcision makes me a "racist anti-Semite." But it seems Edgar Schoen can get away with the bold-faced racism that he is demonstrating here.

In Edgar Schoen's world, only circumcised, non-Hispanic white males count as being "American." This can be pardoned, and one can only pass as being truly "American," if a male comes from an affluent household, and has been circumcised. If an American boy is not circumcised, it is because he is a son to Hispanic immigrants, or low-income white folks. (And therefore don't count as being "American"?) It sounds as though Edgar Schoen would like to supplant American culture with his own culture of origin, where being circumcised is a mark of being Jewish, and not being circumcised makes you an outcast. (Although, according to tradition, a male is Jewish whether he be circumcised or not, if his mother is Jewish.)

It is interesting, the numbers Schoen wishes to quote from the CDC. 89% sounds very impressive, although this number denotes the number of adult males who are circumcised from birth. The fact is, however, that, according to the CDC, the rate of infant circumcision in this country has fallen to approximately 56%, from 80-90% in the 1980's.

Perhaps, at one time, circumcision was "the norm," in this country, but not so much anymore.

Schoen fails to mention the downward trend of male infant circumcision in this country because it doesn't paint his desired reality.

He also fails to hide his true interest in infant circumcision:

"The exception is a small number of middle-class boys whose parents
have been convinced by activist anti-circumcision groups to leave their
baby boys “intact,” as they call it. Parents targeted by lay
anti-circumcision groups are usually well educated, secular and liberal,
live in coastal “blue” states and are attracted to alternative/holistic
medical practice.

Many
Jews fall into this profile, so that now, thousands of years after the
covenant between Abraham and God mandating circumcision on the eighth
day (Genesis 17), we see Jewish boys with foreskins."

Schoen also happens to be Jewish, where male infant circumcision is considered to be a divine commandment, and a cherished tradition that has been defended since the time of the Maccabees. Schoen's religious conviction to male infant circumcision is in direct conflict with his feigned interest in disease prevention and public health. Here we note the disdain he has as he witnesses circumcision vanish as a Jewish tradition before his very eyes.

Schoen continues:

"The Bay Area is
ground zero for activist organizations gunning against circumcision,
such as NOCIRC, NOHARMM and Intact."

Well, at least he has one thing right...

"The arguments of these cultlike
groups are based on anecdotes, testimonials, false theories and bogus
claims with no scientific support."

Something that has always struck me as disconcerting, entertaining at times, is circumcision advocates' incorrigible projection. For example, intactivists are always being accused of being "cultlike," who always use "false theories" and have "no scientific support." We're also accused of being circumcision "fetishists," but we'll get into that later.

We must ask, what are Schoen's arguments based on?

I challenge readers to look through the current literature. Who wrote it? On what is it based? What do circumcision advocates like Schoen pass off as "scientific support?" They will find that much of the so-called "research" is nothing more than glorified opinion, written by the self-same usual suspects who are looking to vindicate circumcision, based on theories which have either not ever been proved, or even been dis-proven.

"Recently, as compelling medical evidence demonstrates the significant
health advantages of circumcision on newborns, there has been a flurry
of desperate activity by anti-circumcision groups, as they see their
cause being decimated," says Schoen.

But rather than furnishing said "compelling medical evidence," he goes on a tirade against human rights advocates who oppose male infant circumcision. The decimation of the intactivist cause is something Schoen would like to see materialize, though this does not easily come about by the mere shroud-waving he engages in. Actually, far from being decimated, our cause is going strong and it has circumcision advocates running scared, as readers will see.

"They picketed the local office of the American
Academy of Pediatrics, and the executive director had to call the
police. At an AAP meeting in San Francisco in July, I was harassed by
anti-circumcision protesters, leading the hotel to assign me a security
guard. This all followed last year’s unsuccessful attempt to criminalize
infant male circumcision in San Francisco."

And that's not all. After publishing their latest statement, many letters of criticism were written by intactivists from within and outside notable organizations, but cowards at the AAP have refused to publish them. (We know that there are letters that do not appear on the AAP website
because a number of human rights activists published them openly. They are viewable here and here.)

Strangely enough, while they won't publish dissenting letters from
intactivists, despite being fully referenced, they will publish Brian Morris praising the new AAP policy statement and tooting his own horn.
(Brian Morris is quite possibly Australia's most vocal advocate of male infant circumcision. View his "Welcome" of the new policy here. I rebuke him here, although this too has yet to be published.)

It is clear that the AAP and circumcision advocates like Schoen are intimidated by intactivists, because they are
able to take apart their arguments and call them out on
their ulterior motives. The AAP knows their latest policy statement is
horrendously flawed, and they are terrified to let groups like Intact America speak
on the matter, because they don't want to be confronted with the truth. The extent to which the AAP has gone to silence intactivism, that Schoen would rather hide behind a hotel security guard, shows just
how terrified they are of our message, how weak their position actually
is, and how inept they are at defending it.

To me, these are the actions of guilty criminals squirming under the light of scrutiny.

The AAP has released a horrendously flawed statement they cannot
actually substantiate. Circumcision advocates like Schoen are too scared to confront intactivists. They know it, and they don't want to be
confronted with anybody who can give them a run for their money.

Westin employee defending Schoen from all of ONE protester.

"The documented evidence of the lifetime preventive health advantages
of circumcision is overwhelming."

Underwhelming, he means. So underwhelming are the so-called "advantages" of circumcision that no medical organization, yes, not even the AAP, has found it compelling enough to recommend it.

Let us analyze Schoen's usage of the word "lifetime." What does he mean? Does that mean that in a child's lifetime, he is immune to the diseases he mentions? Let it be known; a circumcised male is as susceptible to any disease as an intact male. Circumcision does not, cannot prevent disease transmission, ever. Circumcised males must continue to use condoms for actual protection, and there is no doctor or "researcher" that can deny this fact.

"This year, the AAP stated that the
significant benefits of newborn circumcision outweigh the minor risks."

They also said that these self-same "benefits" were not enough to recommend the practice, as they did in their last statement. Circumcision enthusiasts like Schoen just love to leave this part out.

"Severe infant kidney infections, which can lead to kidney damage, are 10
times more common in uncircumcised males in the first year of life."

"10 times" certainly sounds compelling, but what is the risk for UTIs in intact males to begin with? It's already quite low. The fact is that UTIs are already quite rare in males; they are far more common in baby girls. When a girl develops a UTI, it is easily treatable with anti-biotics. The same is true with UTIs in boys. It makes no sense to circumcise a child to prevent an already rare, easily treatable ailment. Somehow, I doubt we'll hear this from Dr. Schoen.

"The
presence of a foreskin leaves a young boy susceptible to painful local
infections (balanoposthitis) and inability of retraction (phimosis)."

The question is, how common are these diseases? And are they treatable without circumcision?

"In sexually active years, circumcision provides 60 percent greater
protection against HIV/AIDS, which has killed over 20 million people in
Africa and tens of thousands in this country. The United Nations, the
World Health Organization and the National Institutes of Health have all
endorsed circumcision to help prevent HIV/AIDS."

The "research" this claim is based on has been continuously under fire. One of the biggest flaws in this "research" is that the much fabled "60%" is not observable in real-world data. The research is not based on a scientifically proven causal link, but on some un-proven, and even dis-proven hypotheses.

According to USAID, HIV transmission was more prevalent among
*circumcised* men in 10 out of 18 African countries. The HIV transmission rate
is far higher in the US, where according to Schoen himself, over 80% of
the male population is circumcised, than it is in Europe, where
circumcision is rare.

But even assuming the so-called "research" to be 100% infallible, the fact of the matter is that circumcision fails as HIV prevention. It fails so drastically to prevent anything that even the authors of the "studies" cannot overstate the use of condoms.

But whats' more, the UN and WHO (which are basically the same organization) have endorsed circumcision in promiscuous ADULT MALES in high-risk areas in Africa. Dr. Schoen would like to sell the fantasy that there is this world-wide campaign to circumcise the children of the world as a HIV prevention measure. Such a campaign does not exist.

*Might* help protect, Schoen means to say. The evidence is inconclusive, which is why no physician in the right mind will recommend circumcision as a way to prevent any of these diseases; they stress the use of condoms. The fact is that circumcised males are still susceptible to these diseases, and partners of circumcised males are still susceptible to HPV transmission and bacterial vaginosis. Some research actually suggests that the HPV is more easily transmitted by circumcised males.

Continues Schoen: "The advantages in old men
include avoidance of penile cancer and urinary infections, which are
prevalent in the elderly, as well as easier genital hygiene in the
incapacitated."

In the past, circumcision has been
suggested as a way to prevent penile cancer. This was based on studies
that reported much lower penile cancer rates among circumcised men than
among uncircumcised men. But in many of those studies, the protective
effect of circumcision was no longer seen after factors like smegma and
phimosis were taken into account.

Most public health researchers believe that the risk of penile cancer
is low among uncircumcised men without known risk factors living in the
United States. Men who wish to lower their risk of penile cancer can do
so by avoiding HPV infection and not smoking. Those who aren't
circumcised can also lower their risk of penile cancer by practicing
good hygiene. Most experts agree that circumcision should not be
recommended solely as a way to prevent penile cancer.

Geriatric care facilitation seems to be a common theme amongst circumcision advocates. Schoen is not the first to use it, as Daniel Halperin has before. (Daniel Halperin is one of the "researchers" working hard to flood the medical literature with pro-circumcision "research." His office is only a stone's throw away from Edgar Schoen's office.") Hygiene in the elderly is an interesting theme to tackle. The majority of the elderly in Europe are not circumcised, and difficulty in cleaning intact males doesn't seem to be a problem there. It is interesting that Schoen and Halperin suggest circumcision as a way to facilitate hygiene in elderly males, instead of better instruction of geriatric caretakers. Then again, Halperin and Schoen share the same culture of origin. (Both Jewish and vehement advocates of male infant circumcision.)

Continues Schoen: "The newborn period is the ideal time for circumcision."

And here begins Schoen's shameless circumcision plug. "Not only does
early circumcision lead to a lifetime of health advantages..."

Fact: There is no disease that a circumcised man, circumcised at any age, will be immune against in his lifetime. Dr. Schoen cannot deny this.

"...but it is
the easiest and safest time to perform the procedure."

False; it is harder to circumcise a newborn because of the small size of the penis. The small size of the penis makes it more susceptible to glans amputation, or full ablation of the penis. Many a lawsuit has been won against over-zealous mohels and physicians. It is easier and safer to circumcise an adult male, because there is more penis to work with, and because analgesia can be properly administered, not to mention that advances in technology have spawned new devices that simplify circumcision for adult mails, as we will read about later on.

"After the trauma
of birth, a newborn is programmed to deal with distress."

Babies were just born to be tortured! How about that. The same distress a baby girl would have to deal with, right? Oh no! Perish the thought.

"Stress
hormones, such as hydrocortisone and adrenaline, are extremely high, as
is the pain-relieving compound endorphin. The male hormone,
testosterone, is often in the adult range. All these hormone levels fall
within the first few weeks of life."

These hormones shoot up high as a result of circumcision. Schoen does not mention this.

"The newborn foreskin is thin..."

Not thin enough. One of the most common complications of circumcision is hemorrhage. This happens when the foreskin is not fully crushed. If an open circumcision wound is not sutured in time, the child can easily bleed to death, as it has already happened in many cases.

Now I see where Neil Pollock (also friends with Schoen, also Jewish) gets his propaganda.

Schoen's claims depend on a few dubious premises; a) that analgesia methods are actually used, and b) that if and when used, they are actually effective. Circumcising physicians may use Tylenol, sugar pacifiers, a topical cream, and/or a local anesthetic injection called a dorsal penile ring block. Research shows, however, that most physicians, as much as 96%, do not use analgesia. The topical anesthetic only serves to numb the area to lessen the pain
of the injection, but studies have shown that a dorsal penile ring
block is not always effective in stopping the pain of circumcision. (See here and here.) In at least one study, data shows that giving sugar to a child doesn't help to reduce the perception of pain in the child. And, of course, none of these do anything for post-operative pain, and for the pain the child must endure during recovery.

Once again, Schoen is living in a dreamworld.

"Healing is rapid, and complications, usually minor,
are less than 0.5 percent."

"...with a longer recovery
time and a tenfold higher complication rate."

It'd be nice to see the research Schoen uses for this claim.

"The need for general
anesthesia makes the procedure riskier."

"Riskier?" Dr. Schoen must correct me if I'm wrong. But isn't the use of general anesthesia become LESS risky as a child grows into an adult?

Almost all circumcision deaths
have been due to complications from general anesthesia."

Again, I would like to see what medical literature Schoen backs this claim with.

If general anesthesia is Schoen's concern, then he hasn't been paying attention to the latest developments in adult circumcision in Africa. Is he aware of the new PrePex device being marketed to circumcise adult males in Africa as a so-called HIV prevention measure?

If we're to believe PrePex CEO Tzemeret Fuerst (Can you guess her culture of origin?), the new device requires no surgery, no anesthetic, and the complication rate is rather low. As more devices like these are invented, the myth that "circumcision is much more riskier in adult males" becomes less and less true.

"As noted, uncircumcised males, compared with those who are
circumcised, are prone to many health dangers from birth through old
age..."

Which are not observed in countries where circumcision is rare...

"...and also may have social problems in the United States, where
circumcision is the standard."

This one is increasingly laughable to hear. In other words, European and Asian men have much trouble finding a partner. Is this observable behavior in the real world?

The fact is, genital hygiene can be improved without circumcision. And losing part of your penis means LESS varied sexual relations, not MORE. Once again, it is quite self-evident that Edgar Schoen is growing more and more senile.

"Above all, Jewish
men with foreskins are abandoning an ancient family tradition and
culture."

Note "above all." Here, Schoen's true concerns come to light, which is the gradual, but sure, abandonment of what is probably the most cherished of Jewish customs; NOT disease prevention and public health. It is disingenuous to be feigning an interest in public health and disease prevention, when true intentions and convictions lie elsewhere.

"Dr. Edgar J. Schoen is the former chief of pediatrics at Kaiser Permanente in Oakland and clinical professor of pediatrics, emeritus, at UCSF. He lives in Richmond."

He is also the most vociferous advocate of male infant circumcision in the United States. He is also Jewish and has a religious conviction to defend and protect this custom, which is falling out of favor, even among Jews themselves. His feigned interest in disease prevention and public health conflict with a conviction to preserve a cherished tradition.

Edgar Schoen: Rejected Circumcision Evangelist

America is not the only place where Schoen has tried to establish his dreamworld. Apparently he is a circumcision evangelist who has tried to (unsuccessfully) spread his vision to other parts of the world. The following is an excerpt of a letter written against him in the publication Disease in Childhood:

Schoen’s claims have been rejected wherever he goes. When he
published in the New England Journal of Medicine in 1990, his views were
opposed by Poland. When he published in Acta Paediatrica Scandinavia in
1991, his views were rebutted by Bollgren and Winberg. When Schoen
published in this journal in 1997, his views were countered by
Hitchcock and also by Nicoll. In the present instance, his views are
offset by Malone.

When the Canadian Paediatric Society published their position
statement on neonatal circumcision in 1996, they followed the views of
Poland, not those of Schoen. Although Schoen was chairman of the
American Academy of Pediatrics (AAP) taskforce on circumcision that
published in 1989, he did not serve on the AAP taskforce on circumcision
that published in 1999. That second taskforce distanced the AAP from
the views published by Schoen’s taskforce a decade earlier.

(In their latest statement, the AAP continues to abstain from
endorsing male infant circumcision, concluding that the benefits, even though they purportedly "outweigh the risks," are still
“not enough” to recommend the practice.)

Schoen’s present views on circumcision are strikingly similar to
those of Wolbarst, which were published nearly a century ago. This
suggests that Schoen’s views are founded in a desire to preserve his
culture of origin, not in medical science.

Edgar Schoen, the Circumfetishist?
Edgar Schoen has a few peculiar quirks readers may or may not know about. First, he is a collector of large bow ties. In most pictures of him, you will always see him wearing one.

My, he sure prefers black and white pictures of himself, doesn't he.

In addition to his love for bow ties, Edgar Schoen is a poet, and he has written verses exalting the beauty of the circumcised penis. He appeared on the Penn and Teller show "Bullshit" for their episode on circumcision, where he can be quoted saying circumcised penises look and smell better. He can also be seen reciting some of his poetry:

"It's a great work of art like the statue of VenusIf you're wearing a hat on the head of your penis"
~Edgar J. Schoen

The "hat" presumably referring to the visible glans?

But what I find to be most disconcerting concerning Schoen is his involvement with known circumfetish groups Circlist and Gilgal Society. Groups such as these openly admit to a morbid fascination with circumcision to the point of
sado-masochistic fetish. They advertise that doctors are among
their members. There are those on the Internet who discuss the erotic
stimulation they experience by watching other males being circumcised,
swap fiction about it, and trade in videotapes of actual
circumcisions. Some call them "circumfetishists."

Could it be that his obsession with penis cutting extends even further than culture preservation?

One thing is for sure. Edgar Schoen is a veteran circumcision evangelist whose time has come. It seems after all this time he is stuck in a time warp, still living in a time when being circumcised was the mark of being an affluent American. That time has been slowly fading, and it seems he, and a number of dedicated circumcision advocates, are working hard to try and roll back the clock. He's an old fart whose logic and reasoning are beginning to fail. (Some may argue this may have happened a long time ago.)

The times have changed, and he is but a living fossil in a world that no longer needs nor wants him. When is he going to finally kick the bucket and sail off to his idealistic dreamworld of the land of the mutilated penis?

Disclaimer:

The views I express in this blog are my own
individual opinion, and they do not necessarily reflect the views of all
intactivists. I am but an individual with one opinion, and I do not
pretend to speak for the intactivist movement as a whole.

Some may argue that I am engaging in ad hominem. However, pointing out
conflicts of interest is not ad hominem. The following is an excerpt
from Wikipedia's entry on ad hominem (4/22/2012):Conflict of Interest: Where a source seeks to convince by a claim
of authority or by personal observation, identification of conflicts of
interest are not ad hominem – it is generally well accepted that
an "authority" needs to be objective and impartial, and that an
audience can only evaluate information from a source if they know about
conflicts of interest that may affect the objectivity of the source.
Identification of a conflict of interest is appropriate, and concealment
of a conflict of interest is a problem.

5 comments:

Another great article, Joseph! Just one small suggestion. Is this right? "Research shows, however, that very few physicians, as little as 96%, ever use analgesia."I think you mean 4% here. Thanks for all you do to inform and protect!

I was struck by the violent metaphor of"The Bay Area is ground zero for activist organizations gunning against circumcision, such as NOCIRC, NOHARMM and Intact."

Whether by "Ground Zero" he's thinking of Hiroshima/Nagasaki, when predominantly circumcised Americans attacked intact Japanese, or 2001, when circumcised Muslims attacked Americans, the violence of the imagery is at odds with what is actually happening in the Bay Area - people are persuading others not to attack the genitals of babies with knives.

His "poems" are printed in full at http://www.circumstitions.com/Schoens.html. The whole piece is written in sarcasm, and the "hat" in the line you quote is the foreskin, but its a confused mess, so it's not at all clear.

"If an American boy is uncircumcised, it generally means his parents are immigrants, usually Hispanic, or low-income."

Here Schoen unwittingly reveals a deep and long standing driver of American routine infant circumcision: The notion that having a natural penis means that one was born to impoverished parents, oblivious to hygienic and sexual propriety.

In a word: Snobbishness.

"...[intact men] may have social problems in the United States, where circumcision is the standard."Schoen was born in 1925. How would a man his age know the state of erotic play in bedrooms occupied by college age and 20 somethings experimenting sexually before settling into a committed relationship?? Has Schoen ever talked to women like Lacy Green? Carlin Ross? Molly McFly (who is Jewish)?

"...easier genital hygiene leads to improved and more varied sexual relations."'More varied' is a dubious conclusions of Laumann et al (1997). The willingness to admit to sex acts beyond vaginal intercourse is correlated with education. Education is in turn correlated with family circumstances which are also correlated with RIC. And how in the world does one quantify the quality of sexual relations? And without such quantification, how can one say that circumcision improves sexual relations?

Schoen is a provincial product of upper middle class urban California during the first half of last century. The stratified America of his youth no longer exists. The Bay Area and the rest of California have moved on; Schoen hasn't.

Circumcision is seldom a medical issue, but instead is almost entirely a major unsolved problem in the social psychology of human sexuality. This is especially in countries like the USA, where deference to religious mandates is not invoked.

Like you said, the research is amazing: "Severe infant kidney infections, which can lead to kidney damage, are 10 times more common in uncircumcised males in the first year of life."

The original study (by Wiswell) compared fullterm circumcised boys with uncircumcised prematurely born boys. A fair number of the premature boys had had catheters inserted, as well as other physical and immunological problems. Yep, the research was ridiculously invalid and has been discredited.

Chances of penile cancer: 1 in 100,000. If circumcision prevented penile cancer, 99,999 boys would have to be circumcised uselessly for 1 old man to not have cancer. And, it is a very easy cancer to cure in the early stages (it is a form of skin cancer).

Oh, and the 60% figure: 1% of circumcised men and 1.6% of uncircumcised men acquired HIV in a study in which less than half the men overall were followed up and in which the study was ended early when the results started looking bad.